The Fladen Eye Center specializes in the diagnosis and treatment of ocular disease. Specialized fields of ophthalmic testing include cataract, cornea, glaucoma, neuro-ophthalmology, and retina. We use these instruments to digitally image normal and abnormal eye structures. All our exams are completely digital and can be emailed to the patient or to a referring doctor for their analysis. We have over 300,000 images taken by our highly sophisticated state of the art Imaging and Analyzing Instrumentation. These Diagnostic Imaging Devices are used for patients Without disease to verify normal ocular structure at no cost to the patient and are performed during every eye exam.
Our technicians are highly trained. We are also certified in numerous clinical studies helping to grant FDA approval for the latest medications. We see such a large volume of patients with a vast array of diagnoses. We receive referrals to our center locally and nationally in our rehabilitation of visual loss for our research protocols.
We perform the following test procedures:
- Zeiss Humphrey Visual Field Analysis
- Ptosis Visual Field
Optical Coherence Tomography
- Zeiss Cirrus 5000 with Highest Resolution Imaging Capabilities; measured in microns for both the front and back segments of the eye. We have thousands of images which assist Dr. Fladen in the earliest diagnosis of cornea disease, problems from Lasik, macular degeneration and glaucoma.
- Fundus and optic nerve photography (mydriatic and non-mydriatic)
- Slit lamp photography
- Gonio photography
- External photography
- IOL Master
- A scan biometry with or without IOL calculations
- Color vision (100 hue and D-15)
The Farnsworth-Munsell 100 Hue and the Farnsworth Munsell D-15 tests consist of colored caps to be arranged in correct color order under controlled lighting conditions.
The D-15 test is used as a fast screening method for dichromatic type defects, while the 100 Hue gives more complete information of discrimination ability around the color chart.
The test administrator records chip arrangements on a standard sheet.
A fundus camera, or retinal camera, is a specialized low power microscope with an attached camera designed to photograph the interior surface of the eye, including:
- Optic disc
- Posterior pole (i.e. the fundus).
Fundus cameras are used by optometrists, ophthalmologists, and trained medical professionals for monitoring progression of an ocular disease, diagnosis of a disease, or in screening programs, where the photos can be analyzed later. Measuring the ratio of the optic cup, documenting a choroidal nevus, or tracking dry ARMD are some of the more common uses of fundus photography.
Fundus photography is also used in clinical trials in order to monitor the effect of new medications and also to have them approved by the FDA.
Humphrey Visual Field Analysis
The primary function of the Humphrey visual field machine is to measure the patient’s peripheral and central vision with repeated light stimulus of varying intensities appearing in different parts of the field while the eye is focused on a central spot. The results are then compared with those of the age-matched normal population.
Visual field testing is performed for screening for glaucoma. Another function is to measure the severity of lid droop of ptosis of the eyelid. Testing for macular diseases such as macular degeneration or toxicity from certain medications such as Plaquenil used for rheumatoid arthritis. Testing can also be performed for the following:
- The visual pathways to the brain,
- The visual or occipital cortex and optic nerve looking for:
- Brain swelling injury
- Poor circulation
A baseline test is performed with follow-up testing within one to three months, six to 12 months, or yearly to compare results is advisable.
The Zeiss IOL master is an optical device that measures the distance from the corneal vertex to the retinal pigment epithelium by partial coherence interferometry. The IOL master is the first such device to be widely used in clinical ophthalmology calibrated against the ultra-high resolution 40 mhz Grieshaber Biometric System.
The IOL Master allows fast, accurate measurements of the eye length and surface curvature necessary for cataract surgery, that is axial length, anterior chamber and width to width. And because the IOL Master is non-contact (nothing touches the eye itself), there is no need for anesthesia nor potential for spread if contamination from the IOL Master. The patient is seated comfortably and positioned in a chin rest similar to what is typically used for a slit lamp. The overview mode is used for course alignment; the patient looks at a small, yellow fixation light.
Clinical situations may interfere with the partially coherent light beams and decrease the sound/noise rate to the point that preclude a meaningful measurement. These situations include:
- A mature or darkly brunescent lens
- Central posterior subcapsular plaques
- Anterior cortical spokes
- Corneal scars that pass through the visual axis
- Vitreous hemorrhages
In the typical ophthalmology practice, approximately 90% of patients can be measured successfully using the IOL Master. The remaining 10% of patients must be measured by A-scan ultrasonography for the reasons outlined above.
Non-mydriatic Fundus Photography
A fundus camera, or retinal camera, is a specialized low-power microscope with an attached camera designed to photograph the interior surface of the eye, including:
- Optic disc
Posterior pole (i.e. the fundus).
Fundus cameras are used by optometrists, ophthalmologists, and trained medical professionals for monitoring progression of an ocular disease, diagnosis of a disease, or in screening programs, where the photos can be analyzed later.
A non-mydriatic camera is useful for those patients who should not be dilated, like a patient with narrow angle glaucoma or papillary defects. There are occasions when a patient’s pupil just won’t dilate well and the mydriatic camera is unable to obtain as clear of a view of the fundus.
data which gives a precise geometric description of the anterior eye segment. This data in turn can be used to generate data on elevation, curvature, pachymetry, depth of the anterior chamber and more…
Slit Lamp Camera
The slit lamp camera is an instrument that consists of a high-intensity light source that can be focused to shine a thin sheet of light into the eye. It is used in conjunction with a biomicroscope.
The lamp facilitates an examination of the anterior segment, or frontal structures of the human eye, which includes:
The binocular slit-lamp examination provides a stereoscopic magnified view of the eye structures in detail, enabling anatomical diagnosis to be made for a variety of eye conditions.
The slit beam serves as a great tool for documentation and can be manipulated to obtain a multitude of visual effects, which can illuminate the area of interest. This can help to dictate the severity of a disease, like how many layers a mass may be penetrating through, how narrow the anterior chamber angle is, or how dense a cataract is.